Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Missouri Cvs Pharmacy, LLC

Organization Diabetes Educator Registered Nurse · NPI 1073098901

Missouri Cvs Pharmacy, LLC is a Diabetes Educator Registered Nurse in Fenton, Missouri. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

45 Gravois Bluffs Plaza Dr
Fenton, MO 63026-4012
Phone: (636) 343-5488
Fax: (636) 343-3851
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X
Diabetes Educator Registered Nurse Taxonomy 163WD0400X
Medical Specialty Clinic/Center Taxonomy 261QM2500X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1073098901
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Susan Colbert — Sr. Director, Payer Relations · (401) 770-2751
Other names Cvs Pharmacy #18052; Schnucks Pharmacy 212
NPI enumeratedSeptember 26, 2018
Last updated in NPPESJune 29, 2020
Certification dateJune 29, 2020
Mailing address1 Cvs Drive, Box 1075, Woonsocket, RI 02895-6164

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